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Online Violence Reporting form

Page One

We've tracked homophobic harassment, bias & prejudice motivated violence, family, relationship and intimate partner violence & other incidents of violence including lateral violence in Victoria against & within the LGBTi communities for 20 years. Making a report helps us to support you, assists in designing effective programs to support victims, to prevent harassment, family violence & hate crime from occurring and to work towards the development of third-party and assisted reporting systems.

IF YOU ARE IN IMMEDIATE DANGER
CALL POLICE ON 000

SPEAK WITH THE OPERATOR AND TELL THEM THE MATTER IS URGENT

When you are safe, please let us know of your experience.  We will assist you in making contact with police and other services.

WE ADVOCATE FOR THE ESTABLISHMENT OF THIRD-PARTY & ASSISTED REPORTING SERVICES LIAISING WITH POLICE IN VICTORIA, WHICH IS LGBTi COMMUNITY-LED & FUNDED TO DO SO!

1. You've experienced violence. Was it a spur-of-the-moment incident or was it pre-planned?
10. Nature of the Incident
(Please select as many choices that apply) *This question is required.
11. Was the person being violent in a relationship with you or the victim/s?
12. When language was used by the perpetrator, was it
19. Has this event been reported to police?

This information in this section will be separated from any identifying information in the next section, to protect your privacy.

24. What is your gender?
25. Cultural background - Are you

The next section is about you. This information is confidential and between you and us - we will respect & protect your privacy.

If you want us to share your information with another person/s or organisation, you MUST indicate that you consent to this.

29. Do you consent to us sharing this information? *This question is required.
30. Who would you like us to contact on your behalf?
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